Non–Time-Loss and Time-Loss Softball Injuries in Secondary School Athletes: A Report From The National Athletic Treatment, Injury and Outcomes Network (NATION)

Document Type


Publication Date



Ó by the National Athletic Trainers’ Association, Inc Context: Most studies of injury trends associated with softball focus on injuries requiring at least 24 hours of missed participation time (time-loss [TL] injuries), with little focus on those that do not (non–time-loss [NTL] injuries). A better understanding of injury trends associated with softball will improve athlete care. Objective: To describe NTL and TL injuries experienced by secondary school girls’ softball players. Design: Descriptive epidemiology study. Setting: Secondary school athletic training clinics. Patients or Other Participants: Secondary school girls’ softball players. Main Outcome Measure(s): Aggregate data were collected from schools participating in the National Athletic Treatment, Injury, and Outcomes Network surveillance program during the 2011–2012 through 2013–2014 academic years. Frequencies and rates of injuries (NTL and TL) according to time of season, event type, body part injured, and diagnosis were analyzed. Results: In total, 1059 injuries were reported during 140 073 athlete-exposures (AEs): overall injury rate ¼ 7.56/1000 AEs. Of these injuries, 885 (83.6%) were NTL (NTL rate ¼ 6.32/1000 AEs) and 174 (16.4%) were TL (TL rate ¼ 1.24/1000 AEs). Of the NTL and TL injuries, the largest numbers occurred during the regular season (NTL: n ¼ 443 [50.1%]; TL: n ¼ 131 [75.3%]). Injuries sustained during practices accounted for the majority of NTL and TL injuries (NTL: n ¼ 631 [71.3%]; TL: n ¼ 104 [59.8%]). The NTL injuries occurred most often at the shoulder (n ¼ 134 [15.1%]) and hand/fingers (n ¼ 109 [12.3%]) and were diagnosed as contusions (n ¼ 316 [35.7%]), strains (n ¼ 157 [17.7%]), and abrasions (n ¼ 151 [17.1%]). The largest numbers of TL injuries were to the head/face (n ¼ 71 [40.8%]) and diagnosed as concussions (n ¼ 50 [28.7%]) and strains (n ¼ 28 [16.1%]). Conclusions: Secondary school softball players sustained a larger proportion of NTL injuries than TL injuries. Although NTL injuries may be less severe, they are numerous. Efforts are needed to ensure that injury-prevention programs are incorporated into the care of softball athletes to promote health and reduce injury occurrence.